Coping and emotional adjustment in hospital settings

How can psychology help in hospital settings?

Support hospital services through pacing and goal setting for rehabilitation, psychological preparation for surgery, confidence building, support for allied health professionals to improve psychological and communication skills, and direct psychological work with patients, families, and carers.

What is emotional adjustment in the hospital?

Adjustment to illness or procedures, influenced by age, gender, and characteristics of the illness or injury.

What is coping?

The process by which people try to manage stress; efforts may reduce stress, lead to acceptance without solution, or avoidance of the situation.

What are the two main coping styles?

Emotion-focused coping and problem-focused coping.

What is emotion-focused coping?

Aimed at controlling the emotional response to a stressful situation; behavioural responses include drinking, seeking emotional support, or distraction; cognitive responses include reframing the situation positively.

What is problem-focused coping?

Aimed at reducing demands of a stressful situation or expanding resources to deal with it; examples include quitting a stressful job, seeking medical treatment, or negotiating deadlines.

How do people generally use coping approaches?

Billings & Moos (1981): people used more problem-focused than emotion-focused methods; women reported more emotion-focused coping; higher income and education correlated with greater problem-focused coping; death in family led to less problem-focused coping.

What are two ways hospital patients try to cope?

Ascribing blame and exerting control over their care.

How does ascribing blame affect adjustment?

Blaming self or others can worsen adjustment; blaming others often leads to poorer adjustment than self-blame (Downey, Silver & Wortman, 1990; Bulman & Wortman, 1977; Kiecolt-Glaser & Williams, 1987; Taylor, Lichtman & Wood, 1984).

What happens when patients try to exert control in hospital and fail?

They may become helpless, leading to feelings of depression and behaving as the 'good patient' (Raps et al., 1982).

How can healthcare providers help patients cope in hospital?

Provide constructive suggestions and advice, psychological counselling, and opportunities to share experiences with other patients.

What are examples of effective coping support?

Constructive advice during anaesthesia improves recovery (Evans & Richardson, 1988); counselling post-heart attack reduces hospital stay, complications, depression, and anxiety (Gruen, 1975); sharing a room with a patient recovering from the same procedure reduces anxiety and shortens stay (Kulik & Mahler, 1987).

What is psychological preparation for surgery?

Methods to reduce stress associated with medical procedures, including cognitive control, behavioural control, and informational control.

What is cognitive control in surgery preparation?

Focusing on the benefits of the procedure and not its unpleasant aspects; reduces preoperative stress (Langer, Janis & Wolfer, 1975).

What is behavioural control in surgery preparation?

Performing actions to reduce discomfort or promote recovery, e.g., special breathing exercises.

What is informational control in surgery preparation?

Gaining knowledge about events or sensations to expect during or after the procedure.

How can cognitive control be enhanced?

By focusing on positive aspects rather than negative, which improves outcomes and reduces stress (Langer, Janis & Wolfer, 1975).

How can informational and behavioural control be enhanced?

Using videos of patients who underwent the procedure and demonstrating exercises to aid recovery.

What is the main source of stress for pre-school children in hospital?

Separation anxiety from primary caregivers (Ainsworth, 1973, 1979).

What reactions might young children have to hospitalisation?

Becoming less sociable, bedwetting, temper tantrums, anxious behaviour at home, nightmares, or increased attachment to primary caregiver.

Why do young children react strongly to hospitalisation?

Limited logical reasoning leads to misconceptions, e.g., believing illness or treatment is punishment.

How do school-age children respond to hospitalisation?

They tolerate separation better, but may worry about limited independence, illness outcomes, being away from friends, and exposing their bodies to strangers.

How can parents help children cope with hospital procedures?

By endorsing positive thinking to help both themselves and the child cope (Pinquart, 2013).

How can siblings support coping in hospitalised children?

By providing peer understanding, presence, and support during the hospital stay.

What strategies do children use to cope?

Young children may use play; older children may use games, art, or music to distract from procedures and pain.

What did Nabors et al. (2018) find about family resilience?

Families were resilient; cognitive strategies like reframing or positive appraisal were used; siblings acted as protectors and helpers; children used distraction to cope.

What psychological preparation can hospitals provide for children?

Training in coping skills and relaxation, and use of puppets to demonstrate medical procedures.